氨曲南致肌酶水平升高

Elevated muscle enzyme levels due to aztreonam

1例47岁女性患者因盆腔炎给予氨曲南1.0 g入0.9%氯化钠注射液250 ml静脉滴注2次/d,替硝唑0.4 g静脉滴注2次/d,保妇康栓1粒/d(阴道给药)。用药第4天患者出现乏力,实验室检查示肌酸激酶(CK)764 U/L,乳酸脱氢酶(LDH)357 U/L,α-羟丁酸脱酸酶(α-HBDH)293 U/L。次日停用氨曲南,其他药物未变。停用氨曲南第5天乏力缓解,CK 257 U/L,LDH 351 U/L,α-HBDH 162 U/L;第9天乏力消失,CK 166 U/L,LDH 331 U/L,α-HBDH 156 U/L,均在正常范围内。

A 47-year-old female received an IV infusion of aztreonam 1.0 g in 0.9% sodium chloride 250 ml twice daily,an IV infusion of tinidazole 0.4 g twice daily and vaginal administration of one Baofukang（保妇康）suppository once daily for pelvic inflammation.Four days after drug administration,the patient developed asthenia.Laboratory tests revealed the following levels： creatine kinase（CK） 764 U/L,lactate dehydrogenase（LDH） 357 U/L,α-hydroxybutyrate dehydroge nase（α-HBDH） 293 U/L.Aztreonam was withdrawn and her other medications remained unchanged.On the fifth day after aztreonam withdrawal her asthenia improved.She had a CK level of 257 U/L,a LDH level of 351 U/L and a α-HBDH level of 162 U/L.On the ninth day after aztreonam withdrawal,her asthenia disappeared.Her CK（166 U/L）,LDH（331 U/L） and α-HBDH（156 U/L） levels were within normal range.